Registration Form for COVID-19 Discounted Mobile Internet Data Bundles for University Students and Faculty

Kindly note that all personal data collected shall remain confidential and shall not be released to any third parties. All data shall be handled according to Kenya Data Protection act and will be used for academic purposes only.

Surname *

Other Names *

Gender *

Institutional Email Address *

Please use Institutional email like doe@seku.ac.ke. Make sure you are able to login to the email account as it will be used for verification.

Name of Institution *

Please Select Your Category *

Other Category *

National ID / Passport Number

Student /Staff Number *

What 3G/4G Mobile Internet SIM cards are on your smartphone or your smartphones *

You can select all the providers for numbers you want to register for subsidized internet bundles

Safaricom Number *

Airtel Number *

Telkom Number *

Equitel *

JTL (Faiba 4G) Number *

Name of other SIM Card *

Number of other SIM Card *

Location : In what county are you currently staying? *

Mombasa Sub-counties *

Kwale Sub-counties *

Kilifi Sub-counties *

Tana River Sub-counties *

Bura|Bura Galole|Galole Garsen|Garsen

Lamu Sub-counties *

Taita Taveta Sub-counties *

Garissa sub-counties *

Wajir sub-counties *

Mandera sub-counties *

Marsabit sub-counties *

Isiolo sub-counties *

Meru sub-counties *

Tharaka Nithi sub-counties *

Embu sub-counties *

Kitui sub-counties *

Machakos sub-counties *

Makueni sub-counties *

Nyandarua sub-counties *

Nyeri sub-counties *

Kirinyaga sub-counties *

Muranga sub-counties *

Kiambu sub-counties *

Turkana sub-counties *

West Pokot sub-counties *

Samburu sub-counties *

trans Nzoia sub-counties *

Uasin Gishu sub-counties *

Elgeyo Marakwet sub-counties *

Nandi sub-counties *

Baringo sub-counties *

Laikipia sub-counties *

Nakuru sub-counties *

Narok sub-counties *

Kajiado sub-counties *

Kericho sub-counties *

Bomet sub-counties *

Kakamega sub-counties *

Vihiga sub-counties *

Bungoma sub-counties *

Busia sub-counties *

Siaya sub-counties *

Kisumu sub-counties *

Homa Bay sub-counties *

Migori sub-counties *

Kisii sub-counties *

Nyamira sub-counties *

Nairobi sub-counties *

Do you have access to a laptop or a desktop computer where you are currently staying? *

Desktop

Laptop

None

What is the source of electricity in your household or house for your ICT devices *

Other *

What is your current monthly expenditure on mobile Internet bundles *

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Registration Form for COVID-19 Discounted Mobile Internet Data Bundles for University Students and Faculty